Affective bias predicts changes in depression during deep brain stimulation therapy

IntroductionDeep brain stimulation (DBS) is a promising treatment for refractory depression, utilizing surgically implanted electrodes to stimulate specific anatomical targets within the brain. However, limitations of patient-reported and clinician-administered mood assessments pose obstacles in eva...

Full description

Saved in:
Bibliographic Details
Main Authors: Brian Cui, Madaline M. Mocchi, Brian A. Metzger, Prathik Kalva, John F. Magnotti, Jess G. Fiedorowicz, Allison Waters, Christopher K. Kovach, Yvonne Y. Reed, Raissa K. Mathura, Camille Steger, Bailey Pascuzzi, Kourtney Kanja, Ashan Veerakumar, Vineet Tiruvadi, Andrea Crowell, Lydia Denison, Christopher J. Rozell, Nader Pouratian, Wayne Goodman, Patricio Riva Posse, Helen S. Mayberg, Kelly Rowe Bijanki
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Human Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2025.1539857/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849393272243355648
author Brian Cui
Madaline M. Mocchi
Brian A. Metzger
Prathik Kalva
John F. Magnotti
Jess G. Fiedorowicz
Allison Waters
Christopher K. Kovach
Yvonne Y. Reed
Raissa K. Mathura
Camille Steger
Bailey Pascuzzi
Kourtney Kanja
Ashan Veerakumar
Vineet Tiruvadi
Vineet Tiruvadi
Andrea Crowell
Lydia Denison
Christopher J. Rozell
Nader Pouratian
Wayne Goodman
Patricio Riva Posse
Helen S. Mayberg
Kelly Rowe Bijanki
author_facet Brian Cui
Madaline M. Mocchi
Brian A. Metzger
Prathik Kalva
John F. Magnotti
Jess G. Fiedorowicz
Allison Waters
Christopher K. Kovach
Yvonne Y. Reed
Raissa K. Mathura
Camille Steger
Bailey Pascuzzi
Kourtney Kanja
Ashan Veerakumar
Vineet Tiruvadi
Vineet Tiruvadi
Andrea Crowell
Lydia Denison
Christopher J. Rozell
Nader Pouratian
Wayne Goodman
Patricio Riva Posse
Helen S. Mayberg
Kelly Rowe Bijanki
author_sort Brian Cui
collection DOAJ
description IntroductionDeep brain stimulation (DBS) is a promising treatment for refractory depression, utilizing surgically implanted electrodes to stimulate specific anatomical targets within the brain. However, limitations of patient-reported and clinician-administered mood assessments pose obstacles in evaluating DBS treatment efficacy. In this study, we investigated whether an affective bias task, which leverages the inherent negative interpretation bias seen in individuals with depression, could serve as a reliable measure of mood changes during DBS therapy in patients with treatment-resistant depression.MethodsTwo cohorts of patients (n = 8, n = 2) undergoing DBS for treatment-resistant depression at different academic medical centers completed an affective bias task at multiple time points before and after DBS implantation. The affective bias task involved rating the emotional content of a series of static photographic stimuli of facial expressions throughout their DBS treatment. Patients' ratings were compared with those of non-depressed controls to calculate affective bias scores. Linear mixed-effects modeling was used to assess changes in bias scores over time and their relationship with depression severity measured by the Hamilton Depression Rating Scale (HDRS-17).ResultsWe observed significant improvements in total affective bias scores over the course of DBS treatment in both cohorts. Pre-DBS, patients exhibited a negative affective bias, which was nearly eliminated post-DBS, with total bias scores approaching those of non-depressed controls. Positive valence trials showed significant improvement post-DBS, while negative valence trials showed no notable change. A control analysis indicated that stimulation status did not significantly affect bias scores, and thus stimulation status was excluded from further modeling. Linear mixed-effects modeling revealed that more negative bias scores were associated with higher HDRS-17 scores, particularly for positive valence stimuli. Additionally, greater time elapsed since DBS implantation was associated with a decrease in HDRS-17 scores, indicating clinical improvement over time.DiscussionOur findings demonstrate that the affective bias task leverages the inherent negative interpretation bias seen in individuals with depression, providing a standardized measure of how these biases change over time. Unlike traditional mood assessments, which rely on subjective introspection, the affective bias task consistently measures changes in mood, offering potential as a tool to monitor mood changes and evaluate the candidacy of DBS treatment in refractory depression.
format Article
id doaj-art-29d6dcbcedb14ca38245c8f637e0ba03
institution Kabale University
issn 1662-5161
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Human Neuroscience
spelling doaj-art-29d6dcbcedb14ca38245c8f637e0ba032025-08-20T03:40:29ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-03-011910.3389/fnhum.2025.15398571539857Affective bias predicts changes in depression during deep brain stimulation therapyBrian Cui0Madaline M. Mocchi1Brian A. Metzger2Prathik Kalva3John F. Magnotti4Jess G. Fiedorowicz5Allison Waters6Christopher K. Kovach7Yvonne Y. Reed8Raissa K. Mathura9Camille Steger10Bailey Pascuzzi11Kourtney Kanja12Ashan Veerakumar13Vineet Tiruvadi14Vineet Tiruvadi15Andrea Crowell16Lydia Denison17Christopher J. Rozell18Nader Pouratian19Wayne Goodman20Patricio Riva Posse21Helen S. Mayberg22Kelly Rowe Bijanki23Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United StatesOttawa Hospital Research Institute, University of Ottawa, Ottawa, ON, CanadaNash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesNash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesSchool of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesSchool of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United StatesDepartment of Neurosurgery, University of Texas Southwestern, Dallas, TX, United StatesDepartment of Psychiatry, Baylor College of Medicine, Houston, TX, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesDepartment of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United StatesDepartment of Neurosurgery, Baylor College of Medicine, Houston, TX, United StatesIntroductionDeep brain stimulation (DBS) is a promising treatment for refractory depression, utilizing surgically implanted electrodes to stimulate specific anatomical targets within the brain. However, limitations of patient-reported and clinician-administered mood assessments pose obstacles in evaluating DBS treatment efficacy. In this study, we investigated whether an affective bias task, which leverages the inherent negative interpretation bias seen in individuals with depression, could serve as a reliable measure of mood changes during DBS therapy in patients with treatment-resistant depression.MethodsTwo cohorts of patients (n = 8, n = 2) undergoing DBS for treatment-resistant depression at different academic medical centers completed an affective bias task at multiple time points before and after DBS implantation. The affective bias task involved rating the emotional content of a series of static photographic stimuli of facial expressions throughout their DBS treatment. Patients' ratings were compared with those of non-depressed controls to calculate affective bias scores. Linear mixed-effects modeling was used to assess changes in bias scores over time and their relationship with depression severity measured by the Hamilton Depression Rating Scale (HDRS-17).ResultsWe observed significant improvements in total affective bias scores over the course of DBS treatment in both cohorts. Pre-DBS, patients exhibited a negative affective bias, which was nearly eliminated post-DBS, with total bias scores approaching those of non-depressed controls. Positive valence trials showed significant improvement post-DBS, while negative valence trials showed no notable change. A control analysis indicated that stimulation status did not significantly affect bias scores, and thus stimulation status was excluded from further modeling. Linear mixed-effects modeling revealed that more negative bias scores were associated with higher HDRS-17 scores, particularly for positive valence stimuli. Additionally, greater time elapsed since DBS implantation was associated with a decrease in HDRS-17 scores, indicating clinical improvement over time.DiscussionOur findings demonstrate that the affective bias task leverages the inherent negative interpretation bias seen in individuals with depression, providing a standardized measure of how these biases change over time. Unlike traditional mood assessments, which rely on subjective introspection, the affective bias task consistently measures changes in mood, offering potential as a tool to monitor mood changes and evaluate the candidacy of DBS treatment in refractory depression.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1539857/fullaffective biasfacial emotionmood proxydeep brain stimulationsubcallosal cingulateventral capsule striatum
spellingShingle Brian Cui
Madaline M. Mocchi
Brian A. Metzger
Prathik Kalva
John F. Magnotti
Jess G. Fiedorowicz
Allison Waters
Christopher K. Kovach
Yvonne Y. Reed
Raissa K. Mathura
Camille Steger
Bailey Pascuzzi
Kourtney Kanja
Ashan Veerakumar
Vineet Tiruvadi
Vineet Tiruvadi
Andrea Crowell
Lydia Denison
Christopher J. Rozell
Nader Pouratian
Wayne Goodman
Patricio Riva Posse
Helen S. Mayberg
Kelly Rowe Bijanki
Affective bias predicts changes in depression during deep brain stimulation therapy
Frontiers in Human Neuroscience
affective bias
facial emotion
mood proxy
deep brain stimulation
subcallosal cingulate
ventral capsule striatum
title Affective bias predicts changes in depression during deep brain stimulation therapy
title_full Affective bias predicts changes in depression during deep brain stimulation therapy
title_fullStr Affective bias predicts changes in depression during deep brain stimulation therapy
title_full_unstemmed Affective bias predicts changes in depression during deep brain stimulation therapy
title_short Affective bias predicts changes in depression during deep brain stimulation therapy
title_sort affective bias predicts changes in depression during deep brain stimulation therapy
topic affective bias
facial emotion
mood proxy
deep brain stimulation
subcallosal cingulate
ventral capsule striatum
url https://www.frontiersin.org/articles/10.3389/fnhum.2025.1539857/full
work_keys_str_mv AT briancui affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT madalinemmocchi affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT brianametzger affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT prathikkalva affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT johnfmagnotti affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT jessgfiedorowicz affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT allisonwaters affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT christopherkkovach affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT yvonneyreed affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT raissakmathura affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT camillesteger affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT baileypascuzzi affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT kourtneykanja affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT ashanveerakumar affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT vineettiruvadi affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT vineettiruvadi affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT andreacrowell affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT lydiadenison affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT christopherjrozell affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT naderpouratian affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT waynegoodman affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT patriciorivaposse affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT helensmayberg affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy
AT kellyrowebijanki affectivebiaspredictschangesindepressionduringdeepbrainstimulationtherapy